Prevent Cancer Foundation responds to new draft recommendations from USPSTF on breast cancer screening

The U.S. Preventive Services Task Force (USPSTF) on Tuesday released new draft recommendations on breast cancer screening. These draft recommendations lower the breast cancer screening age from 50 to 40, citing increased rates of breast cancer in younger adults. The Prevent Cancer Foundation^® has long supported beginning breast cancer screening at age 40 and was pleased to see the USPSTF take this positive step to enable more people to be screened. According to the USPSTF, this change could result in 19% more lives being saved.

By screening more people at earlier ages, we can find more cancers early, which is critical because Early Detection = Better Outcomes. It is especially important for Black people with breasts to be screened beginning at age 40. Black people with breasts are at increased risk of breast cancer at earlier ages and have higher mortality rates from breast cancer than other racial and ethnic groups.

The Foundation also applauds the USPSTF for releasing recommendations that are inclusive of all people with breasts, addressing cisgender women as well as transgender men and nonbinary individuals who were assigned female at birth. All people with breasts or breast tissue should talk to their doctors or health care providers about screening options.

People who have dense breasts are at increased risk for breast cancer. Given the USPSTF’s “I” (insufficient evidence) rating for supplemental breast cancer screening with ultrasound or breast MRI for this group, the Foundation calls for more research on the screening needs for those with dense breasts.

These draft recommendations are a step in the right direction, but the Foundation is disappointed the USPSTF is recommending a biennial (every other year) time interval for screening. To catch newly developed cancers or stop previously missed cancers before they have too much time to grow, those getting screened for breast cancer should do so annually.

These draft recommendations, along with their evidence review and modeling report, are open for public comment through June 6, 2023, on the USPSTF website.

The Prevent Cancer Foundation supports following the National Comprehensive Cancer Network (NCCN) guidelines for breast cancer screening:

• For those of average risk, get screened annually with 2D or 3D screening mammography beginning at age 40.
• For those at high risk, talk with your health care provider about annual screening with mammography and supplemental imaging, such as breast magnetic resonance imaging (MRI).

Previously, the Affordable Care Act required insurers to cover (without cost-sharing) screening services that received an “A” or “B” grade from the USPSTF. This insurance coverage is now in jeopardy in the wake of the March 2023 ruling by U.S. District Judge Reed O’Connor in Braidwood Management Inc. vs Becerra. This ruling strikes down the ACA’s coverage requirement for preventive services and applies to USPSTF screening guidelines issued on or after March 23, 2010, including those that have been changed or updated since that date. The Biden Administration is likely to appeal this ruling.

As of this writing, the current Protecting Accessing to Lifesaving Screening (PALS) Act requires insurance coverage with no cost-sharing for breast cancer screening. In the Consolidated Appropriations Act of 2023, the PALS Act was extended through January 1, 2025.

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